Weight loss interventions associated with improvements in several symptoms of PCOS: Study

A systematic review of randomized controlled trials (RCTs) found that weight loss interventions were associated with improvements in some polycystic ovary syndrome (PCOS) symptoms, including improvement in menstrual frequency, and could be considered a routine treatment option for patients with PCOS.

According to the researchers, this is the first review to also show that weight loss interventions were associated with a clinically significant improvement in menstrual frequency, an important outcome identified by those living with PCOS and an indicator for subsequent fertility. This study is published in Annals of Internal Medicine.

Researchers at the University of Oxford comprehensively searched several scientific research databases for RCTs from database inception until June 2024 comparing interventions aiming to reduce weight against usual care or low-intensity weight-loss interventions in people with PCOS.

The researchers conducted this review to address the gap in evidence quantifying the impact of weight loss on the management of PCOS, which makes it particularly challenging for clinicians to advise the potential impacts of weight loss interventions.

Pairs of independent reviewers screened the studies and analyzed the impact of weight-intervention on metabolic markers, hormonal markers, gynecological markers and quality of life compared to offering no additional care, usual care (metformin, oral contraceptives, standard advice) or a lower-intensity weight loss intervention (advice for weight loss without support). Interventions included behavioral interventions (diet or physical activity), current or previously licensed weight loss pharmacotherapy (or those which share a class-effect), bariatric surgery, or combinations of such interventions.

The researchers also spoke with 36 women who have PCOS to better inform their selection of primary outcomes and presentation of findings. The researchers found that weight loss interventions were associated with greater reductions in glycemic control and hormonal markers including the free androgen index (FAI). These findings indicate that weight loss interventions may be an effective tool for PCOS management in applied clinical settings, and clinicians could use these results to counsel patients with PCOS on the improvements in PCOS markers after weight loss and direct them towards appropriate interventions. 

Reference:

Jadine Scragg, Alice Hobson, Lia Willis, MSc, Kathryn S. Taylor, Effect of Weight Loss Interventions on the Symptomatic Burden and Biomarkers of Polycystic Ovary Syndrome: A Systematic Review of Randomized Controlled Trials, Annals of Internal Medicine, https://doi.org/10.7326/M23-3179